Navigating Correlation, Causation, and Interpretation in Resting-State fMR

Abstract

Resting-state fMRI has generated influential insights into large-scale brain organization and contributed to clinically relevant applications, largely through correlation-based measures of cross-regional association in BOLD responses. At the same time, interpreting these statistical associations as reflecting underlying neural interactions requires careful consideration of fundamental methodological constraints. Here, we distinguish two fundamental but often conflated limitations. The first is measurement distortion: the fMRI signal is an indirect and heterogeneous measurement of neural activity, arising from neurovascular coupling, physiology, and measurement-related processes, which can introduce systematic and incompletely characterized biases into estimated correlations. The second is causal non-identifiability: even if correlations perfectly reflected neural synchrony, the resulting correlation structure would not uniquely determine the underlying neural interactions. Using causal reasoning, simulations, and analytic arguments, we distinguish these limitations and examine their consequences for interpretation. Although both apply broadly to fMRI, their implications are particularly important in resting-state analyses, where correlation structure is the primary object of inference in the absence of experimental perturbation. We show that measurement-related biases can distort estimated correlations (e.g., attenuating or in-flating associations and affecting group comparisons) and can produce reproducible patterns that do not necessarily reflect underlying neural relationships, highlighting that statistical reliability does not guarantee biological validity. We further show that graph-theoretic, geometric, and other higher-order representations derived from these correlations do not, by themselves, justify mechanistic interpretation. We argue not against the utility of resting-state fMRI, but for greater precision in interpretation. Our conclusions concern the interpretation of correlation-based analyses rather than their methodological utility. Distinguishing measurement distortion from causal non-identifiability clarifies the inferential boundaries separating descriptive association, predictive utility, and mechanistic interpretation.